Location, activity, and health compliance monitoring using multidimensional context analysis

ABSTRACT

A system and method for monitoring patient activity, location, present health status, and health protocol compliance. The present invention provides a more complete and accurate picture of a patient&#39;s health and safety context through a multi-dimensional user health and safety context analysis. Based on the combined computed health compliance score, calculated activity index, the computed location score, and calculated user health index, an overall user health and safety score is calculated. If the computed overall user health and safety score violates a predefined threshold or threshold range, an alert is transmitted to one or more persons.

CROSS REFERENCED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.62/376,139, filed on 17 Aug. 2016. This application is herebyincorporated by reference herein.

BACKGROUND OF THE INVENTION

Conventional patient and elderly monitoring systems and methodstypically involve tracking their location and monitoring either apatient's medical compliance or a patient's one or more physiologicalparameters. These monitoring systems or methods, however, do not providemedical personnel, for example, who normally need to attend to manypatients on the same day, with a relatively complete and accuratepicture regarding a patient's health and safety at a given time andplace. Typically, a patient's health and safety context requires morethan just two parameters to determine whether a patient or an elderlyresident really needs immediate assistance in one form or another. Thus,the greater the number of data types fed into a monitoring system, theless chances that false alarms will be generated. False alarms arecostly in terms of the time, money, and emotional distress anduncertainty they bring to family members, especially when a family hasto constantly deal with other family members such as very young childrenor other sick relatives.

The online article “Doctor's Orders: Mobile Solutions for MedicationTherapy Management” by T. Holland, c. 1995-2016(https://insights.samsung.com/2016/01/21/doctors-orders-mobile-solutions-for-medication-therapy-management/)discloses a medication dispenser and communication hub that providesgeofencing and alert capabilities and connection to various medicaldevices such as blood pressure cuffs and pulse oximeters. US PatentApplication No. 20140077946 discloses a wearable device that can be usedto monitor a patient's location and as part of a mesh network formonitoring patient compliance. The journal article Diagnostics 2014,vol. 4, No. 3, pp. 104-128 discloses radar responsive tags with smartdiagnostic skin patches for use in patient location and physiologicalparameter monitoring.

BRIEF SUMMARY OF THE INVENTION

The present invention generally relates to a method for monitoringpatient activity, location, present health status, and health protocolcompliance. In particular, the present invention provides a morecomplete and accurate picture of the user's health and safety contextthrough a multi-dimensional user health and safety context analysis. Ina preferred embodiment, the multi-dimensional user health and safetycontext analysis is a weighted multi-dimensional user health and safetycontext analysis. In another preferred embodiment, the method of thepresent invention further comprises using a learning algorithm tofurther enhance the accuracy and reliability of the overall user contextanalysis.

The method of the present invention comprises acquiring one ore more ofthe following user information: the user's most-recently assigned healthprotocol, historical activity and medical records, frequently-visitedplaces, user's current location, and one or more scheduled activitiesfrom a user's personal record. The patient undergoes monitoring via anat least one monitoring device to determine at least the user complianceto the acquired user's most-recently assigned health protocol. Based onthe determined patient compliance, an at least one compliance score iscomputed.

The present invention further comprise computing a user location scorecalculated using at least one of current user location, historicalactivity record, frequently-visited places, and one or more scheduleduser activities. In addition, the present invention comprisescalculating a user activity score based on at least one of the user'shistorical activity record, medical record, frequently-visited places,user's current location, and one or more scheduled user activities.

A user health index is also calculated based on measured one or morephysiological parameters and comparison with corresponding one or morepreset physiological parameter thresholds. Based on the combinedcomputed health compliance score, calculated activity index, thecomputed location score, and calculated user health index, an overalluser health and safety score is calculated. If the computed overall userhealth and safety score exceeds or lies outside a predefined thresholdor threshold range, an alert is transmitted to one or more persons,e.g., a family member or medical personnel.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide a furtherunderstanding of the invention, are incorporated herein to illustrateembodiments of the invention. Along with the description, they alsoserve to explain the principle of the invention. In the drawings:

FIG. 1A and FIG. 1B are flowcharts illustrating a preferred embodimentof the method of the present invention.

FIG. 2 is a flowchart illustrating an unweighted calculation of a totalpatient health and safety index or score.

FIG. 3 is a flowchart illustrating a weighted calculation of a totalpatient health and safety index or score.

FIG. 4 is a block diagram of a monitoring system according to apreferred embodiment of the invention.

FIG. 5 shows a multiparameter monitoring system according to a preferredembodiment of the invention.

DETAILED DESCRIPTION OF THE VARIOUS EMBODIMENTS OF THE INVENTION

The present invention is directed to a method of user health and safetymonitoring based on a multi-dimensional user health and safety contextanalysis. In a preferred embodiment of the present invention, the userhealth and safety context analysis is a weighted multi-dimensionalcontext analysis. The method of the present invention comprises:acquiring a user's most-recently assigned health protocol, historicalactivity record, medical record, frequently-visited places, current userlocation, and one or more scheduled user activities; monitoring via anat least one monitoring device a user compliance to the acquired user'smost-recently assigned health protocol; computing an at least one healthcompliance score based on the monitored user compliance to the acquireduser's most-recently assigned health protocol; measuring the user's oneor more physiological parameters; comparing the measured user's one ormore physiological parameters with corresponding one or more presetphysiological parameter thresholds; calculating a user health indexbased on the measured one or more physiological parameters andcomparison with the corresponding one or more preset physiologicalparameter thresholds.

The present invention also comprises computing a location scorecalculated using at least one of the acquired current user location,historical activity record, frequently-visited places, and one or morescheduled user activities; and calculating a user activity score basedon at least one of the user's historical activity record, medicalrecord, frequently-visited places, user's current location, and one ormore scheduled user activities.

The present invention further comprises computing an overall user healthand safety score based on the computed health compliance score,calculated user health index, calculated activity score, and thecomputed location score; and sending an alert when the computed overalluser health and safety score exceeds a predefined threshold.

The calculation of these scores involves not just a straightforwardbinary determination of whether or not a patient has taken his or hermedication, whether or not a patient is in a particular location, orwhether or not the patient performed an activity prescribed by thepatient's primary physician. For example, the calculation of the healthcompliance score preferably additionally takes into account otherparameters that includes a patient's age, known level of cognitive,motor and coordination skills, pre-existing medical conditions, latestmedical diagnosis, prohibited activities based on known one or moremedical conditions, required or typical rest schedules or sleepingtimes, required physical exercises or schedule of sessions with aphysical therapist or trainer, scheduled hospital or doctor visitations,etc. Each of these parameters are assigned an appropriate score, whichdepending on the parameter type, may be a binary 1 or 0 score, or basedon a scale such as 0-5 with 5 corresponding to very important and 0being not required. In another embodiment, a score may assume or beassigned a negative value in cases where the detected patient activityor location, for example, is prohibited, not recommended, or previouslydetermined to be unsafe. Under this scoring scheme, the lower theoverall health and safety score is, the more likely that an alert isgoing to be issued (e.g., when the calculated total score exceeds orgoes below a preset threshold) based on a predicted unsafe patientsituation or predicament.

The location-based score, on the other hand, is based on, for example,whether a patient or user being tracked is in a location deemed unsafeor safe. In a preferred embodiment, all locations, facilities,residences, buildings (e.g., church, grocery stores, friends' houses,gym, clinic, hospital, barber shop, movie houses, etc.) that a patientfrequently or regularly visits or is expected to visit, and all othernearby places or locations that are accessible to the patient, whetherdeemed safe or unsafe for the patient, are initially inputted into themonitoring system's locations database. Preferably, each of thoseentered location is assigned an initial default score (e.g., “+1” forthe church or barber shop within the neighborhood or “−1” for the deeplake a few miles away from the patient's home). The initial defaultscore assigned to any of the recorded locations may later be modifiedif, for example, the location's safety classification has changed (e.g.,from unsafe to safe). In one embodiment, a previously unvisited,unrecorded, or unclassified patient location inputted later into thelocations database is initially assigned a score of “0” (zero) untilverified to be safe or unsafe.

The overall location score preferably includes the case in which thepatient moves from one location to at least one other location over agiven period. Locations deemed safe may be assigned a positive score toindicate that the patient's location is relatively safe such asresidences of family members and relatives, hospitals, clinics, church,schools, gyms, movie theaters, malls, and supermarkets. The overallscore tracking can be performed intermittently, repeatedly based on apreset time interval, or continuously over a given period. Continuousmonitoring may be preferable when the patient is being monitored, forexample, after being discharged from a hospital after a major operationor procedure, or when the patient is undergoing medical observation fora still unverified but potentially serious medical condition.

Alternatively, geofencing could be used to assign a score to variousregions on a map rather than score specific locations. In addition, itis also contemplated that the system could be adaptive and detect vitalsigns of a patient and adjust the location score based on the detectedhealth parameters. In this way, new locations could be automaticallyscored without needing to manually determine its particularclassification. Data may be shared across the entire patient populationto populate these maps. For instance, if the patient typically hasheightened blood pressure without a corresponding increase inrespiration rate, that may be indicative of stress. Such a location mayhave its score decreased to indicate that it is a location thatdecreases health. By way of example, the location score could bedecreased by 0.5 if it resulted in a modest increase in blood pressure,decreased by 1 if it resulted in a moderate increase in blood pressureand a 1.5 if it resulted in an extreme increase in blood pressure. Ofcourse, other weightings could be contemplated without deviating fromthe scope of this invention.

The activity-based score is calculated according to, for example,whether a monitored patient is engaging in activities recommended by hisor her primary physician, physical therapist, or fitness coach.Preferably, the activity-based score is calculated partly by comparingthe detected or identified activity being performed by the patient witha previously scheduled list of activities for the day stored in adatabase or a handheld device. For example, if the patient was detectedto be performing brisk walking on a treadmill in a gym, which matchesone of the patient's scheduled activities for that day, then the presentinvention assigns a corresponding score for that particular activity forthat day under an overall activity score. In one embodiment of thepresent invention, a lower score (or a higher score, depending on thescoring system used) is assigned if the patient is performing anactivity other than a scheduled activity for that time or time intervalof the day. For example, an activity score of “1” may be assigned in thecase wherein the actual activity being performed by the patient matchesthat scheduled in the patient's calendar for that particular time of theday. If instead of a scheduled aerobic exercise session, the patient wasdetermined by the system to be located in a library, the system may beset to assign a score of “0” inferring that the patient is likely to bein indulging in a leisure activity that is neither recommended norprohibited for the patient. In a third case, the system may be preset toassign an activity score of “−1” if the patient was determined to beperforming a prohibited activity, for example, the patient was runningalong a nature trail or a treadmill even though the patient's physicianpreviously recommended that the patient avoid certain types of exercisessuch as running while the patient is still recovering from a previousknee injury.

After calculating the health compliance score, health index,activity-based score, and location-based score for a given patient oruser, the combined score is compared with a preset threshold todetermine whether an alert needs to be sent. Preferably, the monitoringsystem also determines based on the compared combined score at leastwhether the alert needs to be transmitted to relatives only or to bothmedical personnel and relatives. Preferably, the alert specifies boththe specific condition and location of the patient that triggered thealert. In another preferred embodiment, an alert mode corresponding to acritical level medical or health alert also sounds off an audible alarmthat people within the patient's vicinity could hear to notify them thatthe patient needs to be brought to the nearest medical facility.Preferably, the public alert includes an address or phone number to becalled when a critical-level public alert is set off.

FIG. 1A is a flowchart illustrating a preferred embodiment of the methodof the present invention. In the first step, the monitoring systemacquires at least one of a user's most-recently assigned healthprotocol, historical activity record, medical record, frequently-visitedplaces, current user location, and one or more scheduled user activities(step 100). After the initial data acquisition, the monitoring systemperforms monitoring via an at least one monitoring device a usercompliance to the acquired user's most-recently assigned health protocol(step 102). An at least one health compliance score is then computedbased on the monitored user compliance to the acquired user'smost-recently assigned health protocol (step 104). The system alsomeasures the user's one or more physiological parameters (step 106) andthen compares the measured user's one or more physiological parameterswith corresponding one or more preset physiological parameter thresholds(step 108).

Continuing to FIG. 1B, the method of the present invention then proceedsto calculating a user health index based on the measured one or morephysiological parameters and comparison with the corresponding one ormore preset physiological parameter thresholds (step 110). Then alocation score is calculated using at least one of the acquired currentuser location, historical activity record, frequently-visited places,and one or more scheduled user activities (step 112). After calculatinga user location score, the system also calculates a user activity scorebased on at least one of the user's historical activity record, medicalrecord, frequently-visited places, user's current location, and one ormore scheduled user activities (step 114). After calculating theindividual scores, an overall user health and safety score based on thecomputed health compliance score, calculated user health index,calculated activity score, and the computed location score is calculated(step 116). If the computed overall user health and safety score exceeds(or falls below, depending on the scoring scheme adopted) a predefinedthreshold, the monitoring system will send an alert to one or morecontact persons or locations (step 118).

FIG. 2 is a flowchart illustrating the calculation of an unweightedtotal patient health and safety index or score. The first step comprisescalculating a patient health score based on one or more measuredphysiological parameters and comparison with corresponding predefinedparameter thresholds (step 200). Following this, the monitoring systemcalculates a health compliance score (step 202), patient location score(step 204), and a patient activity score (step 206). An overall patienthealth and safety index or score is then calculated by summing all ofthe individual scores for the patient health, compliance, location, andactivity (step 208).

FIG. 3 is a flowchart illustrating the calculation of a weighted totalpatient health and safety index or score. The first step comprisescalculating a patient health score based on one or more measuredphysiological parameters and comparison with corresponding predefinedparameter thresholds (step 300). Following this, the monitoring systemcalculates a health compliance score (step 302), patient location score(step 304), and a patient activity score (step 306). After calculatingeach of the four individual scores, the system then determines therelative importance of each of the calculated scores (step 308). Afterdetermining the scores' relative importance, the monitoring systemassigns a corresponding weight to each of the calculated scores based onthe determined relative importance of the patient health, compliance,location, and activity (step 310). The system then multiplies each ofthe calculated scores by their corresponding weights (step 312). Anoverall patient health and safety score is computed by adding theproduct of weight and score corresponding to each of patient health,compliance, location, and activity (step 314).

In a preferred embodiment, the total patient health and safety index iscalculated using the equation Total Score=b₁x₁+b₂x₂+b₃x₃+b₄x₄, whereb_(i) (i=1, 2, 3, 4) represent the weights of the various parameters x₁,x₂, x₃, and x₄ (e.g., x₁=location score, x₂=total compliance score,x₃=total health status index, x₄=activity score). For example, if thetotal compliance score x₂ and total health status index x₃ areconsidered more critical than the other two terms (x₁ and x₄) under thecurrent patient context because the patient did not take hisbeta-blocker and the measured patient physiological parameters aresomewhat higher than normal, then b₂ and b₃ are preferably assignedhigher values than b₁ and b₄, e.g., b₁=0.2, b₂=0.3, b₃=0.3, and b₄=0.2.Thus, if x₁=+1, x₂=−1, x₃=−2, and x₄=+1, then the TotalScore=(0.2)(+1)+(0.3)(−1)+(0.3)(−2)+(0.2)(+1)=−0.5. For this scoringsystem, a more negative Total Score means a greater likelihood that analarm needs to be sent to one or more patient contact persons (which maybe a family member, a case worker, a nurse, or a physician), dependingon the preset alarm threshold. For example, if the preset alarmthreshold for this type of situation is zero, then an alert will be sentto the appropriate alert recipients. But if the preset alarm thresholdwas initially set at −1.0, then no alert will be transmitted because thecalculated weighted Total Score=−0.5 did not go below the preset alarmthreshold.

In a preferred embodiment, a constant is added to a weighted sum of theindividual terms corresponding to the user location score, user activityscore, current health status, and user health score, wherein theconstant represents a combined values or scores of the other parametersthat remain unchanged regardless of variations in the patient'sactivities and locations (but which nonetheless remain essential todetermine a user's overall health and safety context).

FIG. 4 is a block diagram of a monitoring system according to apreferred embodiment of the invention. The system comprises themultiparameter patient monitoring device 422 connected to at least onenetwork server 400. The patient monitoring device 422 comprises a sensormodule 424 that includes a heart rate sensor 426, motion sensor 428,temperature sensor 430, location tracker 432, and other sensors 434 suchas a blood pressure monitor, oxygen saturation monitor, weight scale,temperature sensor, blood pressure sensor, respiratory sensor.Alternatively, each of the sensors may be separately housed. The patientmonitoring device 422 also comprises a bus 436, processor 438, memory440, communications module 442, graphical user interface 444, and powersource 446. The patient monitoring device 422 is connected via theInternet, cloud, or a local network to at least one server 400 thathouses several databases that include a locations database 410, patientrecord database 408, physiological parameter database 406, and patient'scontacts database 404. The patient monitoring device 422 and the server400 may be configured to allow access by at least one family member orrelative 420 and a primary physician 418 via the Internet, cloud, orthird-party service provider so that the relative 420 or primaryphysician 418 may input new data and delete or modify previously storeddata.

The locations database 410 store data relating to various locations,facilities, residences, buildings (e.g., church, grocery stores,friends' houses, gym, clinic, hospital, barber shop, movie houses, etc.)that a patient frequently or regularly visits or is expected to visit,and all other nearby places or locations that are accessible to thepatient, as well as default classifications (e.g., safe or unsafe) orinitial or default scores for those location data. The patient recorddatabase 408 is where the patient's medical record are stored includingthe most recent required treatment protocol that the patient isundergoing, prescribed medications for the patient's one or more currentmedical conditions, preexisting conditions, known allergies, most recentmedical diagnosis, previous diseases, vital signs measurements, etc. Thepatient monitoring device 422 stores patient physiological parameters(e.g., heart rate, blood pressure, and temperature) measured over a spanof time into the physiological parameter database 406, etc. Thepatient's contacts database 404, on the other hand, contains contactinformation (e.g., home and office addresses, phone numbers, andrelationship to patient) of the patient's family members, relatives,primary physician, therapist, friends, co-workers, etc. Preferably,other databases for storing other data such as the patient's calendar ofactivities, appointments, hospital visits, annual check-ups, dentalvisits, and travel plans are included in the main server 400.

FIG. 5 shows a patient with a multiparameter monitoring system thatcomprises at least a mobile device 510, a heart rate sensor 508, motionsensor 506, and an imaging system 502. The mobile device 510 containsthe patient monitoring software or application that managescommunications between the mobile device 510 and the various sensors anddevices. The mobile device 510 is preferably configured to receive datafrom the various sensors and transmit data to other devices anddatabases, as well as send instructions to the various sensors tocollect data or perform physiological parameter measurements. Thepatient monitoring system preferably also includes an imaging system 502to allow images of the patient's surroundings at a given location to beuploaded to one or more devices or servers. Using the imaging system502, a family member or relative of the monitored patient may thus beable to remotely view in real-time the patient's present location andsurrounding areas. This would be particularly useful in cases where thepatient is determined to be in a new location unfamiliar or unknown tothe patient's family members or relatives. By viewing the images in realtime, the patient's relatives may be able to immediately gauge whetherthe patient is in a safe or unsafe location or setting and call for helpif necessary. In a preferred embodiment, the images are later stored inthe locations database for later closer inspection and locationclassification as safe or unsafe.

In a preferred embodiment of the invention, the scoring scheme used tocalculate an overall patient health and safety context is a weightedscoring system that assigns appropriate weights for each of thecontributing terms to the overall score, depending on each term'sdetermined level of importance for a given set of patient'scircumstances. The weighted scoring system provides a more accurate andreliable patient monitoring by assigning greater importance to certainterms (parameters or variables) that are more critical to the patient'shealth and safety than other parameters based on the patient's currentcircumstance. Thus, one parameter that was assigned the highest weighton a previous day may be assigned a relatively low weight the followingday to reflect a change in the patient's circumstance.

For example, over the duration of a patient's required two-month weeklypost-surgery hospital visitation, the patient's scheduled hospitalvisits is preferably assigned a relatively greater weight than otherpatient activities and locations (e.g., walk in a park) when calculatingthe patient's overall health and safety context score for that time orday. In another case, a patient has a scheduled hospital visit afterlunch time, but began feeling dizzy and experiencing shortness of breathafter having breakfast. His blood pressure monitor detects a higher thannormal blood pressure and his heart rate monitor also indicates a higherthan normal pulse rate. The monitoring system thus assigns greaterweight to the currently-measured and analyzed patient's physiologicalparameters and the determined current patient health status compared tothe weight previously assigned to the scheduled hospital visit. In thiscase, the monitoring system immediately contacts an emergency hotlineand alerts the patient's primary physician and family members so thepatient can be promptly attended to, even though the patient already hasa scheduled hospital visit after lunch on that day.

Thus, in a preferred embodiment, when the system detects that themeasured one or more critical patient physiological parameters (e.g.,heart rate or blood pressure) exceed the corresponding one or morephysiological parameter thresholds, the system ignores all othercontributions to the overall health and safety score (e.g., scheduledactivities and previously planned trips) and quickly sends an alert toone or more individuals or locations (e.g., hospitals, doctor's office,and home of a relative or family member). Thus, the system allowsadjustments to previously assigned weights on previously-scheduledpatient activities and locations (or the system simply ignores all othercurrently non-critical patient parameters) to allow the system toprioritize and quickly respond to unforeseen life-threatening patientsituations or context.

In another example, a patient is detected to be non-compliant with atleast one required health protocol (e.g., the patient failed to take hismedicine for coronary heart disease) because the patient overslept andfailed to hear an alert activated by one of the patient's monitoringsensors, e.g., a smart drug-dispensing system that can determine if apatient took his required medications on schedule. Upon determining thatthe patient was already fully awake and has failed to take his ormedications according to the health protocol schedule, the monitoringsystem alerts the patient again to remind him or her to take hismedications. The monitoring system also preferably immediately measuresthe patient's physiological parameters that include his heart rate andblood pressure. The monitoring system determines that the patient'sphysiological parameters all appear to be normal, the patient isdetected to be walking around in a grocery store, but the patient stillhas not taken his medications. At a preset time or time intervals, themonitoring system calculates or assigns the appropriate scores for eachof the detected patient activity (e.g., assign a score of “+1” when thepatient is detected to be walking or sitting), determined patientlocation (e.g., assign also a “+1” when the patient is detected to beinside a favorite neighborhood grocery store), health protocolcompliance (e.g., assign a score of “−1” for failing to take at leastone of his medications), and measured and analyzed physiologicalparameters (e.g., assign a score of “+1” if the physiological parametersare all determined to be within normal ranges). In this case, a positivescore, preferably one that exceeds a predefined threshold, means thatthe patient is in a safe environment and a sound state of health.

In one embodiment, the monitoring system is configured to monitor apatient and acquire new data to calculate a new patient overall healthand safety context at predefined time intervals over a given period,e.g., every hour over a 24-hour period. The time intervals selected formonitoring may be changed by the monitoring system in cases where itdetermines that the patient needs a more frequent monitoring, e.g., thepatient was non-compliant with a required health protocol and ignoredrepeated system reminders to comply. For example, the patient is takingseveral medications, as well as multi-vitamins, daily. If the patientfailed to take his multi-vitamins, the monitoring system may be set toautomatically assign a score of “−0.5” to that part of patientcompliance because failing to take multi-vitamins would not beconsidered critical or life-threatening. But if a patient failed to takehis statin, the monitoring system would preferably assign a score of“−1.0” for that aspect of patient compliance. On the other hand, if thepatient failed to take his beta-blocker, which could potentially belife-threatening, the monitoring system would preferably set a morenegative score, e.g., “−2.0,” for that aspect of patient compliance. Ina preferred embodiment, if the monitoring system determines that apatient's non-compliance is critical or potentially life threatening(e.g., the patient forgot to take his immunosuppressant following akidney transplant), the monitoring system preferably not only sends outalerts to the primary physician and family members regarding thepatient's non-compliance, but also immediately performs vital signmeasurements using the monitoring system's one or more physiologicalsensors.

In a preferred embodiment, the patient's primary physician is authorizedto modify the default score for at least the health compliance part ofthe patient monitoring, either manually during the patient's visit, orremotely. For example, the primary physician tentatively determines thatthe dizziness and skin rashes the patient was experiencing was due tothe patient's reaction to the beta-blocker the patient was originallyprescribed. The primary physician thus informs the patient totemporarily stop taking the beta-blocker for at least a day. The primaryphysician also promptly connects to the patient monitoring systemwirelessly using her tablet and enters her username and password for therequired authentication and authorization steps. Once inside the system,the physician manually resets the default setting for the beta-blockercompliance to a score of “0” temporarily until she has seen the patientthe following day to do further tests to confirm her hunch about thepatient's adverse reaction to the beta-blocker. Once the adversereaction to the previous beta-blocker has been confirmed and a differentbeta-blocker prescribed to the patient, the default score of “−2.0” forbeta-blocker non-compliance is preferably restored by the primaryphysician.

In another preferred embodiment, the method of the present inventionfurther comprises using a learning algorithm to further enhance theaccuracy and reliability of the overall user context analysis. Thelearning algorithm may be based on at least one learning models orapproaches known in the art such as neural networks, Bayesian networks,deep learning, genetic algorithms, association rule learning, etc. Thelearning algorithm enables a multiparameter analysis of a patient'shealth and safety context that allows a sensible calculation, weighing,or prediction of the various variable's contribution to a total healthand safety score that accurately reflects a user's changing patterns ofactivity, health parameter variations, and visited locations. A majorbenefit provided by a learning algorithm is that it minimizes the needfor constant manual inputs by the one or more individuals involved inmonitoring a patient. It also can enhance reliability and consistency indetermining an overall patient health and safety context by minimizingsubjective differences between manual inputs or score assignments madeby different people.

The use of a learning algorithm is particularly useful when, forexample, a user or patient is detected to be following a differentpattern of activity from his or her previously detected activities orvisited locations. For example, a patient may have been regularly seeinga primary physician over a period of months for regular check-ups afterundergoing a surgery. The learning algorithm would thus detect a patternof, say, weekly post-surgery visitations to a hospital by the user, andcalculate a location and activity score and assign a weight to thatlocation and activity that corresponds to a safe location (hospital) anda safe, expected, or recommended activity (doctor visitation). When therequired post-surgery hospital visitations by the patient ends, thepatient will engage in a new pattern of activity and visit old or newplaces, all of which the learning algorithm will detect.

In a preferred embodiment of the invention, a list of locationsconsidered safe or unsafe are entered into a locations database, theinputting or updating of the location data being performed either by anyone of the user, medical personnel, facility staff, family member,caretaker, or relative. In a preferred embodiment, the location databaseis updated as necessary either manually or through one or more learningalgorithms, e.g., when a user visits a new location that was notpreviously stored in the locations database.

In a preferred embodiment, the system of the present inventionautomatically transmits the current location of a patient to one or morealert recipients (i.e., individuals to whom one or more alerts are to besent) if the patient's current location is a previously undetected orunrecorded user location. Preferably, the patient's current location issent to the alert recipients (e.g., primary physician, relative, familymember, or caretaker) for classification by the at least one recipientas either safe or unsafe. For example, if a patient is detected to be inthe vicinity of a deep lake or a neighborhood previously unvisited bythe patient and also unlisted in the patient's locations database, thesystem will relay a message to an attending medical personnel,caretaker, relative, or family member to inform them about the patient'scurrent location. Preferably, the system will also ask the one or moremessage recipients to assign a category for the newly-identified patientlocation, e.g., safe or unsafe. In a preferred embodiment, anidentification or detection of a patient's current location as “unsafe”will automatically trigger the sending of an alert to an emergencyhotline or a notification to one or more of the patient's contactpersons listed in patient's contacts database.

The sensors may be virtually any sensor capable of sensing data about auser, the user's environment, the user's context, the state of variouselectronics associated with the user, etc. The sensors may includeaccelerometers, heart rate sensors, conductance sensors, opticalsensors, temperature sensors, microphones, cameras, etc. These or othersensors may be useful for sensing, computing, estimating, or otherwiseacquiring physiological parameters descriptive of the wearer such as,for example, steps taken, walking/running distance, standing hours,heart rate, respiratory rate, blood pressure, stress level, bodytemperature, calories burned, resting energy expenditure, active energyexpenditure, height, weight, sleep metrics, etc.

The plurality of sensors used according to the present invention, inconjunction with a posture sensor, preferably include any combination ofthe following examples of sensors: activity sensor, inertial sensor,sleep sensor, sound sensor, camera, heart rate or pulse rate sensor,conductance sensor, optical sensor, temperature sensor, and other typesof physiological sensors. Preferably, at least one inertial sensor isused to monitor the position of the user's spine and pelvis. The sensorscan be placed in appropriate areas in the user body using adhesivestrips or pads and other methods known in the art. Preferably, inertialsensors are placed at least on the user's lower back, upper back, andthe pelvis area to allow measurement, for example, of the extent offorward, backward, or sideways bending performed by the user. In someembodiments, the sensors may share hardware in common with a userinterface.

While many useful parameters may be obtained directly from the one ormore sensors, other useful parameters are obtained by “extracting” themfrom other available data (including the sensor data). For example, rawaccelerometer data may be processed to extract a number of steps taken,an estimate of calories burned, or an estimate of an activity beingperformed by the user (e.g., running, playing tennis, biking, etc.)Accordingly, various devices in the system may implement parameterextraction algorithms for processing available parameters (e.g., sensedparameters and other extracted parameters) to generate new parameters.In some embodiments, the sensors may implement such algorithms forparameter extraction in the same device as at least some of the sensorsthat obtain parameters upon which the algorithms depend or for parameterextraction that is local to the user though not necessarily in the samedevice as the predicate sensors. For example, in some embodiments, awearable bracelet may report accelerometer data to a user's mobiledevice, which then applies an algorithm to estimate a number of stepstaken using the accelerometer data. Additionally or alternatively,virtually any device may apply such parameter extraction algorithms,which in some cases may be provided as a service according to thesystems and methods described herein. For example, the reportingframework, present invention, service application device, output device,or some other device (pictured or not pictured) may perform parameterextraction from input parameters available to the device. To the extentthat such other devices may extract parameters that may be used as inputto other services, such other devices may be considered sensorsthemselves. For example, a service application device that processesaccelerometer data to estimate calories burned may also be considered asensor that provides a calorie estimation for other services.

According to various embodiments described herein, sensors may bedivided among two groups: direct reporting sensors and indirectreporting sensors. Direct reporting sensors may include any sensor thatcan be configured (e.g., by the present invention) to transmitparameters to other devices (e.g., the present invention or serviceapplication device). Such configuration may include adding a domain nameor IP address to a configuration file of the direct reporting sensor toindicate a network location to which parameters should be transmitted.As an alternative, another device (e.g., the present invention) mayperiodically request that such parameters be reported. Variousauthentication and authorization may also be performed such as, forexample, configuring the direct reporting sensor with information forconfirming an identity (e.g., a password or public key) of the device towhich parameters will be transmitted. In some embodiments, suchconfiguration may require the user's manual approval.

Indirect reporting sensors, on the other hand, may only reportparameters to predefined entities such as, for example, proprietaryservers of the sensor manufacturer or a framework such as the AWSInternet of Things (IoT) cloud platform. Collectively, these otherentities may be considered to constitute reporting frameworks. Thereporting framework may provide an application programmer's interface(API) for allowing access to the parameters reported by the indirectreporting sensors (and, in some embodiments, parameters extracted by thereporting framework itself). Similar authentication and authorizationmeasures may be taken with respect to the reporting framework andindirect reporting sensors as described above with respect to the directreporting sensors. For example, the present invention may indicate tothe reporting framework (via the API) an identification of theparameters which should be provided to the present invention along witha token indicating the user's approval for such sharing (or useful inobtaining such approval). Thereafter, the reporting framework mayperiodically or upon request transmit such parameters to the presentinvention (or other device such as a service application device).

As another example, the present invention may facilitate thetransmission of parameters between devices by configuring one or moredevices to establish communication among them without the presentinvention acting as an intermediary. For example, the present inventionmay provide an address of the service application device to the relevantsensors or reporting frameworks such that these devices may thereaftertransmit parameters to the service application device. Additionally oralternatively, the present invention may provide the service applicationdevice with the address of the relevant sensors or reporting frameworksfor polling. In some embodiments, configurations of any of these devicesmay also include providing authorization information such as, forexample, an authorization token (e.g., an API token) generated by thepresent invention or other device for presentation upon transmission ofparameters or a request for such a transmission.

Various approaches to enrolling a new sensor may be utilized by thesensor enrollment instructions. For example, in some embodiments, thesensor enrollment instructions may receive an identifier for a sensorfrom a consumer configuration device (e.g., as manually typed in by theuser; captured by a camera via a barcode, QR code, or using opticalcharacter recognition; or received by the consumer configuration devicevia short-range communication such as NFC or Bluetooth) or directly fromthe sensor itself (e.g., as stored in memory at the time ofmanufacturing or registration with a reporting network). In someembodiments, the identifier may be or otherwise include a networkaddress such as a MAC address or IP address. In some embodiments wherethe identifier is, at least in part, dynamic (e.g., an IP address), thesensor enrollment instructions may periodically re-execute to update thedynamic portion of the identifier. Upon receiving the identifier thesensor enrollment instructions may verify the device throughcommunication with, for example, a reporting framework. Additionally,the sensor enrollment instructions may receive authorization inassociation with the device by, again, communicating with another devicesuch as the reporting framework or the sensor itself.

The sensor may also be in the form of a wristwatch wearable device thatincludes an additional accelerometer as well as an optical sensororiented toward the skin of a user to detect color changes. Pedometerinstructions (which may have been installed on the mobile device by orin connection with the present invention) interpret the rawaccelerometer data to output an estimation of the number of steps taken.Alternatively, the pedometer instructions of the mobile device mayreceive raw data from both accelerometers (e.g., as facilitated by thepresent invention) to give an improved estimation of steps taken. Heartrate instructions (which may have been installed on the mobile device byor in connection with the present invention) interpret the raw opticaldata to extract a heart rate parameter. The steps and heart rateparameters, as well as the raw accelerometer data, are provided to theproprietary wristwatch server for storage and further processing. Thewristwatch wearable may not be configurable to share data with any otherdevices and, as such, may be considered an indirect reporting sensor.

The proprietary wristwatch server may be a server, blade, or VMoperated, for example, by a manufacturer of the wristwatch wearable.Upon receiving parameters from the wristwatch wearable, they may bestored in a watch parameter storage and later used by activityidentification instructions to identify a particular activity in whichthe user is engaged. For example, wristwatch accelerometer data may beused in conjunction with a trained model to distinguish playing tennisfrom kayaking. In some embodiments, the present invention may facilitateprovision of additional input parameters (e.g., accelerometer data fromthe mobile device) to the proprietary wristwatch server to improve oractivate operation of the parameter extraction algorithms or otherservices offered by the device manufacturer. The proprietary wristwatchserver additionally includes an external access API for providing someor all of these parameters to the present invention or other devices.

An energy expenditure estimation service VM includes energy expenditureestimation instructions for executing a parameter extraction algorithmthat estimates a number of calories burned from various inputs.Similarly a fitness coaching service VM includes fitness coachinginstructions for processing various input data to provide coachingmessages to the user.

The device of the present invention preferably includes a processor,cache/system memory, user interface, network interface, and storage, andfor some devices, sensors interconnected via one or more system buses.

The processor may be any hardware device capable of executinginstructions stored in memory or storage or otherwise processing data.As such, the processor may include a microprocessor, field programmablegate array (FPGA), application-specific integrated circuit (ASIC), orother similar devices. In some embodiments, such as those relying on oneor more ASICs, the functionality described as being provided in part viasoftware may instead be hardwired into the operation of the ASICs and,as such, the associated software may be omitted.

The cache/system memory may include various memories such as, forexample L1, L2, or L3 cache or system memory. As such, the memory mayinclude static random access memory (SRAM), dynamic RAM (DRAM), flashmemory, read only memory (ROM), or other similar memory devices.

The communication interface may include one or more devices for enablingcommunication with other hardware devices. For example, the networkinterface may include a network interface card (NIC) configured tocommunicate according to the Ethernet protocol. Additionally, thecommunication interface may implement a TCP/IP stack for communicationaccording to the TCP/IP protocols. Various alternative or additionalhardware or configurations for the communication interface will beapparent. In some embodiments, the communication interface may includean NFC, Bluetooth, or other short range wireless interface. Variousalternative or additional hardware or configurations for thecommunication interface will be apparent.

The storage may include one or more machine-readable storage media suchas read-only memory (ROM), random-access memory (RAM), magnetic diskstorage media, optical storage media, flash-memory devices, or similarstorage media. In various embodiments, the storage may storeinstructions for execution by the processor or data upon with theprocessor may operate. For example, the storage may store an operatingsystem for controlling various basic operations of the hardware.

Where the device implements a sensor, the storage may also includesensor polling instructions for periodically on the acquisition of newdata, polling the sensors for new raw data. The storage may also includeparameter extraction algorithm application instructions for executingone or more parameter extraction algorithms to extract additionalparameters from the parameters obtained by the sensor pollinginstructions, other parameter extraction algorithms, or from otherdevices. In some embodiments, the set of parameter extraction algorithmsmay be supplemented by addition of new algorithms (e.g., as a result ofsubscribing to a new service). To enable such extension offunctionality, the parameter extraction algorithm applicationinstructions are adapted to call each of the parameter extractionalgorithms during run-time. For example, in some embodiments, theparameter extraction algorithms may be written using an interpreted code(e.g., JAVA™ or a proprietary device code) while the parameterextraction algorithm application instructions include or invoke anappropriate interpretation engine (e.g., JAVA™ runtime environment orother interpreter). As another example, the parameter extractionalgorithms may instead be compiled code while the parameter extractionalgorithm application instructions may include code that calls eachparameter extraction algorithm in turn. In some embodiments, theextraction algorithm application instructions may be as simple as codethat calls each parameter extraction algorithm in sequence. Variousadditional organizations for expanding algorithm-based functionalitywill be apparent.

The storage may also include parameter reporting instructions fortransmitting parameters sensed by the sensor polling instructions orextracted by the parameter extraction algorithms. For example, where thesensor is an indirect reporting sensor, the parameter reportinginstructions may cause the processor to transmit parameters to areporting framework. Where the sensor is a direct reporting sensor, theparameter reporting instructions may cause the processor to transmitparameters to one or more device identified or authorized in theparameter reporting configurations. The parameter reporting instructionsmay operate periodically, upon the acquisition of new parameters, orupon receiving a pull request from another device.

In some embodiments, such as those wherein the sensor provides someoutput of at least the locally gathered or extracted parameters, thestorage also includes parameter output instructions for causing displayor other output of parameters, for example, upon request by the user. Inembodiments wherein the sensor is also a output device, the parameteroutput instructions may additionally effect output of parameters orother information received from other devices via the remote parameterreceipt instructions. Such remote parameter receipt instructions mayoperate periodically, upon request by the user (e.g., to sync withservice providers or to display a parameter that is remotely obtained),or upon indication from the remote device of the availability of suchparameters to request, receive, interpret, store, or otherwise processremote parameters.

It will be apparent that various information described as stored in thestorage may be additionally or alternatively stored in the memory. Inthis respect, the memory may also be considered to constitute a “storagedevice” and the storage may be considered a “memory.” Various otherarrangements will be apparent. Further, the memory and storage may bothbe considered to be “non-transitory machine-readable media.” As usedherein, the term “non-transitory” will be understood to excludetransitory signals but to include all forms of storage, including bothvolatile and non-volatile memories.

While the device is shown as including one of each described component,the various components may be duplicated in various embodiments. Forexample, the processor may include multiple microprocessors that areconfigured to independently execute the methods described herein or areconfigured to perform steps or subroutines of the methods describedherein such that the multiple processors cooperate to achieve thefunctionality described herein. Further, where the device is implementedin a cloud computing system, the various hardware components may belongto separate physical systems. For example, the processor may include afirst processor in a first server and a second processor in a secondserver.

The user profile also includes a sensors record set for describing thesensors enrolled for the user. The sensors record set includes an inputid field for identifying an enrolled sensor (e.g., a user-provided name,an identifier generated by the present invention, an identifier used byanother device such as a reporting framework, or a globally uniqueidentifier), an input types field for identifying (e.g., using the sameparameter type taxonomy used by the service provider to specify inputsand outputs to a service) input parameters available from the sensor,and indirect field for identifying whether a sensor is a directreporting or indirect reporting sensor, and an authorization token fieldfor storing one or more tokens (e.g., encryption keys, passwords, APItokens, etc.) needed for accessing the data from the sensor. It will beapparent that additional or alternative information about each sensormay be provided by the sensors record set such as, for example, one ormore network addresses of the sensor, one or more network addresses of areporting framework, an indication of whether the present invention mustact as an intermediary to other services (e.g., between the serviceapplication device and a direct reporting sensor or reporting framework)

As an example, a first record indicates that a device is able to providetwo input types: pocket-carried pedometer and pocket-carriedaccelerometer data. This information is directly reported by the sensorand is not associated with any authorization tokens. In variousembodiments, the record may correspond to the mobile device.

A second example record indicates that a device provides three inputparameter types: wrist-worn pedometer, wrist-worn accelerometer, andactivity data. This information is only obtainable from a reportingframework associated with the device using the defined authorizationtoken. In various embodiments, the second record may correspond to thewristwatch wearable or proprietary wristwatch server. This recordidentifies input parameters available from two different sensors: thewristwatch wearable creates the accelerometer and pedometer data, whilethe proprietary wristwatch server extracts the activity data. For thepurposes of sharing or for the purposes of user presentation, however,these two sensors may be collapsed into a single “device” record becauseall three parameters will be obtained from the reporting framework (dueto indirect reporting) or because the user may consider the completesolution offered by the manufacturer (device and reporting framework) toconstitute a single device which they purchased and use.

The present invention is not intended to be restricted to the severalexemplary embodiments of the invention described above. Other variationsthat may be envisioned by those skilled in the art are intended to fallwithin the disclosure.

What is claimed is:
 1. A medical alert method for creating amultidimensional user context analysis comprising: providing a patientmonitoring device comprising one or more physiological sensors, a motionsensor, a location tracker, a processor, a wireless communicationsinterface, a memory device, a graphical user interface, and a powersource, wherein the patient monitoring device is configured to becarried by a user; acquiring the user's most recently assigned healthprotocol and the user's current location; monitoring, via the patientmonitoring device, user compliance to the user's most recently assignedhealth protocol; computing a health compliance score based on themonitored user compliance to the user's most recently assigned healthprotocol; computing a location score using the user's current locationmeasured by the patient monitoring device, the user's historicalactivity record measured by the patient monitoring device,frequently-visited places measured by the patient monitoring device, andone or more scheduled user activities, wherein computing the locationscore is based on determining whether the user's current location is anidentified safe location, an identified unsafe location, or anunidentified new location; computing an overall user health score basedon the computed health compliance score, and the computed locationscore; and sending an alert message to a physician or a caretaker afterthe computed overall health score violates a predefined threshold,wherein the alert message includes the user's current location, a reasonfor the alert, and a request for the physician or the caretaker toprovide an indication of whether the user's current location is safe orunsafe when the user's current location is the unidentified newlocation.
 2. The medical alert method as recited in claim 1, wherein themethod further comprises: acquiring one or more preset physiologicalparameter thresholds; measuring the user's one or more physiologicalparameters; comparing the user's one or more physiological parameterswith the corresponding one or more preset physiological parameterthresholds; and calculating a user health index based on the measuredone or more physiological parameters and comparison with thecorresponding one or more preset physiological parameter thresholds. 3.The medical alert method as recited in claim 2, wherein the user's oneor more physiological parameters comprise heart rate, blood pressure,oxygen saturation, respiration, activity, weight, and temperature. 4.The medical alert method as recited in claim 3, wherein the methodfurther comprises: acquiring a list of the frequently-visited places,and a list of the one or more scheduled user activities; and calculatinga user activity score based on at least one of the user's historicalactivity record, medical record, the list of the frequently-visitedplaces, the user's current location, or the list of the one or morescheduled user activities.
 5. The medical alert method as recited inclaim 4, wherein the overall user health score is further based on thecalculated user health index and the calculated user activity score. 6.The medical alert method as recited in claim 4, wherein the overall userhealth score is calculated as follows: overall user healthscore=b1×1+b2×2+b3×3+b4×4 wherein, b1−Computed health compliance score,×1=Computed health compliance score weighting factor, b2=Calculated userhealth index, ×2=Calculated user health index weighting factor,b3=Calculated activity score, ×3=Calculated activity score weightingfactor, b4=Computed location score, and ×4=Computed location scoreweighting factor.
 7. The medical alert method of claim 1, wherein apatient's primary physician is authorized to remotely modify a defaultscore for the health compliance score.
 8. The medical alert method ofclaim 1, wherein the patient monitoring device is configured to send analert to an emergency hotline after identification of the user's currentlocation as unsafe.
 9. The medical alert method of claim 1, wherein thepatient monitoring device is a wearable device.
 10. The medical alertmethod of claim 9, wherein the wearable device further comprises awristwatch server.
 11. A medical alert system for creating amultidimensional user context analysis comprising: a main servercomprising a first processor and a first memory, a patient recordsdatabase, and a locations database, wherein the patient records databaseinclude a user's most recently assigned health protocol; a patientmonitoring device, comprising one or more physiological sensors, amotion sensor, a location tracker, a second processor, a wirelesscommunications interface, a second memory, a graphical user interface,and a power source, wherein the patient monitoring device is configuredto be carried by a user and monitor compliance of the user; a networkinterconnecting the patient monitoring device with the main server,wherein the main server is configured to compute a health compliancescore based on the monitored compliance and the user's most recentlyassigned health protocol, compute a location score based on the user'scurrent location measured by the patient monitoring device, the user'shistorical activity record measured by the patient monitoring device,frequently-visited places measured by the patient monitoring device, andone or more scheduled user activities, wherein computing the locationscore is based on determining whether the user's current location is anidentified safe location, an identified unsafe location, or anunidentified new location, compute an overall user health score based onthe health compliance score and the computed location score, and send analert message to a physician or a caretaker after the computed overalluser health score violates a predefined threshold, wherein the alertmessage includes the user's current location, a reason for the alert,and a request for the physician or the caretaker to provide anindication of whether the user's current location is safe or unsafe whenthe user's current location is the unidentified new location.
 12. Themedical alert system as recited in claim 11, wherein the main server isfurther configured to calculate an activity score based on the user'shistorical activity record, medical record, the frequently-visitedplaces, the user's current location, and the one or more scheduled useractivities.
 13. The medical alert system as recited in claim 11, whereinthe main server further comprises: a physiological parameter databasecomprising one or more of heart rate, blood pressure, oxygen saturation,respiration, activity, weight, and temperature.
 14. The medical alertsystem as recited in claim 13, wherein the physiological parameterdatabase comprises one or more physiological parameter thresholds, andwherein the main server is configured to calculate a user health indexbased on the measured one or more physiological parameters andcomparison with the corresponding one or more physiological parameterthresholds.
 15. The medical alert system as recited in claim 14, whereinthe locations database includes one or more of the user's historicalactivity record, medical record, the frequently-visited places, theuser's current location, or the one or more scheduled user activities;and the main server is configured to calculate a user activity scorebased on at least one of the user's historical activity record, themedical record, the frequently-visited places, the user's currentlocation, or the one or more scheduled user activities.
 16. The medicalalert system as recited in claim 15, wherein the overall user healthscore is further based on the calculated user health index and thecalculated user activity score.
 17. The medical alert system as recitedin claim 16, wherein the overall user health score is calculated asfollows: overall user health score-b1×1+b2×2+b3×3+b4×4wherein,b1=Computed health compliance score, ×1=Computed health compliance scoreweighting factor, b2=Calculated user health index, ×2=Calculated userhealth index weighting factor, b3=Calculated activityscore,×3=Calculated activity score weighting factor, b4=Computedlocation score, and ×4=Computed location score weighting factor.
 18. Amedical alert method for monitoring patient activity, location, andhealth protocol compliance using a multidimensional context analysiscomprising: providing a patient monitoring device comprising one or morephysiological sensors, a motion sensor, a location tracker, a processor,a wireless communications interface, a memory device, a graphical userinterface, and a power source, wherein the patient monitoring device isconfigured to be carried by a user; acquiring the user's most-recentlyassigned health protocol, the user's historical activity record, medicalrecord, frequently-visited places, tile user's current location, and oneor more scheduled user activities; monitoring, via the patientmonitoring device, user compliance to the acquired user's most-recentlyassigned health protocol; computing a health compliance score based onthe monitored user compliance to the acquired user's most-recentlyassigned health protocol; measuring the user's one or more physiologicalparameters; comparing the measured user's one or more physiologicalparameters with corresponding one or more preset physiological parameterthresholds; calculating a user health index based on the measured one ormore physiological parameters and comparison with the corresponding oneor more preset physiological parameter thresholds; computing a locationscore calculated using the user's current location measured by thepatient monitoring device, the user's historical activity recordmeasured by the patient monitoring device, the frequently-visited placesmeasured by the patient monitoring device, and the one or more scheduleduser activities, wherein computing the location score is based ondetermining whether the user's current location is an identified safelocation, an identified unsafe location, or an unidentified newlocation; calculating a user activity score based on at least one of theuser's historical activity record, the medical record, thefrequently-visited places, the user's current location, and one or moreof the scheduled user activities; computing an overall user health scorebased on the computed health compliance score, the calculated userhealth index, the calculated activity score, and the computed locationscore; and sending an alert message to a physician or a caretaker afterthe computed overall user health score violates a predefined threshold,wherein the alert message includes the user's current location, a reasonfor the alert, and a request, for the physician or the caretaker toprovide an indication of whether the user's current location is safe orunsafe when the user's current location is the unidentified newlocation.